SPECTRUM OF MELIOIDOSIS IN THE SUBURBS OF MANGALORE, S WEST COAST OF INDIA

Abstract. Melioidosis is an emerging infection in India. Seventeen cases of culture proven melioidosis are reported in this study. The isolation rate was high during the rainy season. Except one case, all the patients had diabetes mellitus as an underlying disease. Eleven patients improved with ceftazidime or combination therapy and maintenance therapy with doxycycline and Cotrimoxazole. The high prevalence of B. pseudomallei in this region is a matter for serious concern

Antibiogram of Salmonella Isolates from Blood with an Emphasis on Nalidixic Acid and Chloramphenicol Susceptibility in a Tertiary Care Hospital in Coastal Karnataka: A Prospective Study

Background: Enteric fever is caused by the serotypes Salmonella Typhi, Salmonella Paratyphi A, Salmonella Paratyphi B and Salmonella Paratyphi C. After emergence of multidrug resistant Salmonellae Ciprofloxacin, a fluorquinolone antibiotic was the first-line therapy. Treatment failure was observed with Ciprofloxacin soon and such strains showed in-vitro resistance to Nalidixic acid. Recent reports suggest re-emergence of Chloramphenicol sensitive strains and increasing Nalidixic acid resistance. This study is aimed at detecting the current trend in the antibiogram of Salmonella isolates from blood culture in coastal Karnataka, with an emphasis on antibiotic susceptibility of Nalidixic acid and Chloramphenicol and evaluate, if there is a need to modify the strategies in the antibiotic therapy for enteric fever. Materials and Methods: Blood samples received for culture in the laboratory between June 2009 and August 2011 was cultured in Brain Heart infusion broth, bile broth or in a commercial BACTEC culture media. The growth from blood cultures were processed for identification and antibiotic susceptibility as per standard methods. Antibiotic susceptibility for Ampicillin, Trimethoprim-sulphamethoxazole, Chloramphenicol, Ciprofloxacin, Ceftriaxone and Nalidixic acid were noted. Results: Out of 9053 blood culture specimens received, Salmonella was isolated from 103 specimens. There were 85 Salmonella Typhi isolates, 16 Salmonella Paratyphi A and two Salmonella Paratyphi B. Salmonella Typhi and Salmonella Paratyphi A showed the highest resistance to Nalidixic acid. Salmonella Typhi showed highest susceptibility to Ceftriaxone and Salmonella Paratyphi A to trimethoprim-sulphamethoxazole and Chloramphenicol. Two isolates were multidrug resistant. One Salmonella Paratyphi A was resistant to Ceftriaxone. Conclusion: Routine screening of Nalidixic acid susceptibility is practical to predict fluorquinolone resistance in Salmonella and preventing therapeutic failure while treating with it. It is worthwhile to consider replacing fluorquinolones with Chloramphenicol or Ceftriaxone as the first line of therapy for enteric fever. Periodic analysis of Salmonella antibiogram should be done to formulate the best possible treatment strategies

Changes in Candida Profile in Patients Undergoing Intensity Modulated Radiotherapy for Head and Neck Malignancies

The increased oral Candida colonization that resulted for radiotherapy often leads to candidiasis. Intensity Modulated Radiotherapy (IMRT) is a technique of delivering radiation with improved dose distributions sparing the surrounding normal tissue and decreasing the ill-effects. Objective: To identify and quantify changes in the Candidal carriage of patients undergoing IMRT for head and neck malignancy. Methods: Saliva from 37 patients undergoing IMRT for head and neck malignancy was collected. The Candida species profile pre- and post-IMRT was evaluated using semi quantitative fungal culture. The changes in the distribution of the growth of Candida species due to IMRT was analyzed using Wilcoxon sign rank test. Results: Twenty-two patients were Candida-positive pre-IMRT, while 24 patients were Candida-positive post-IMRT. Candida species isolates pre-IMRT were C. albicans (63%), C. tropicalis (26%), C. glabrata (7%), C. krusei (4%) and post-IMRT, were C. albicans (55%), C. tropicalis (30%), C. glabrata (12%) and C. krusei (3%). C. albicans showed increased growth post-IMRT in the range of 103 to 104 colony-forming units per ml of saliva (p>0.05). Conclusion: There was no significant effect of IMRT on the distribution of growth of Candida. Candida albicans was the most common species. A change towards non C. albicans species post-IMRT was seen.

Effect of IMRT and three-dimensional conformal radiotherapy on oral Candida colonization: A comparative study

Aim: To investigate oral candidiasis in patients with head and neck cancer before and after intensity-modulated radiation therapy and three-dimensional conformal radiotherapy (3D CRT) and to explore if there is an association with the type of radiotherapy used and the severity of candidiasis. Materials and Methods: Patients who received radiation therapy (RT) for the treatment of head and neck cancer were divided into two groups: Group 1 consisted of patients (n = 20) who received Intensity modulated radiation therapy (IMRT) and Group 2 (n = 20) consisted of patients who received 3D CRT. Saliva from these patients was collected before and after radiotherapy and evaluated for Candida species using culture method. Results: Significant increase of Candida albicans was seen in patients who underwent 3D CRT as compared to IMRT. Other species of Candida such as Candida tropicalis, Candida glabrata, and Candida krusei showed increase postradiotherapy in both groups, but the change was not significant. Conclusion: Although candidiasis is seen regardless of the type of radiation therapy used, the oral environment is more stable after intensity-modulated radiation therapy as and when compared to 3D CRT. Salivary substitutes and good oral hygiene before, during, and after radiotherapy could be used to increase oral clearance and to decrease the chance of candidiasis

Detection of Rotavirus and Adenovirus diarrhea in children below five years, in Dakshina Kannada District, a coastal region of Karnataka State, India

Context: Diarrheal disease is the second largest cause of death of children under 5 years. Viral diarrhea is most common which is usually caused by Rotavirus followed by enteric Adenovirus. Rotaviruses are responsible for approximately 527,000 deaths mainly in low-income countries of Africa and Asia. There is limited number of studies done on viral diarrhea in this coastal belt. Aim: To determine the prevalence of Rotavirus and Adenovirus diarrhea among children below 5 years of age and its epidemiological importance in this coastal region of Karnataka State, India. The impact of factors like socio-economic status, drinking water, and Rotavirus immunization status that can contribute to the disease were also evaluated and recommendations are formulated for disease prevention. Materials and Methods: Children below 5 years of age with history of diarrhea, vomiting and fever of less than 3 days were included in this study. The sample size was 35. General physical examination, clinical findings and other details like socio-economic status, personal hygiene, growth milestones and family income were also recorded. A commercial Rotavirus and Adenovirus antigen detection kit was used to detect the presence of Rotavirus and Adenovirus antigen from the stool sample. Results: Out of 35 patients screened, 25 (71.43%) patients were negative for both Adenovirus and Rotavirus, 10 children (28.57%) were positive for Rotavirus and no patients were positive for Adenovirus. Severe dehydration, fever, loose stools and vomiting were the commonest symptoms seen in Rotavirus positive children. The highest incidence of infection with Rotavirus was seen among 7-12 months age group. Children whose stool was positive for Rotavirus used public water supply. Conclusions: Rotavirus is an important cause of diarrhea in children below 5 years in this coastal region. A simple, rapid immunochromatography test is useful and economical tool to simultaneously detect and screen Adenovirus and Rotavirus. Low socioeconomic state and unsafe water supply contributes to diarrheal disease

Spectrum of anaerobes encountered in surgical infections in a tertiary care hospital in Mangalore, coastal Karnataka: A prospective study

Context: Anaerobes are significant pathogens as well as normal flora in a variety of body sites. As the conventional anaerobic culture techniques are laborious, time-consuming and relatively expensive, the interest in anaerobes started narrowing down in the recent past. Objective: This study is aimed at the isolation of bacteria encountered in the surgical infections with an emphasis on anaerobes and to create an awareness among the clinicians regarding the potential role of these silent pathogens Materials and Methods: The present prospective study that was conducted for a period of 1 year, employed 393 specimens collected from various surgical infections. All the samples were subjected for the isolation of both aerobes and anaerobes. Results: Out of 393 specimens, 193 anaerobes and 311 aerobes were obtained. Majority of the cases (226) exhibited polymicrobial etiology. Among the anaerobes, more frequently isolated organisms were nonsporing gram-negative bacilli, such as Bacteroides fragilis group, Prevotella-Porphyromonas group and Fusobacterium, which constitute 68.91% of the cases. Conclusions: This study emphasizes the need to employ anaerobic culture techniques routinely in microbiology laboratories and to create an awareness among the clinicians regarding the potential role of anaerobes

Trends in Influenza Infections in Three States of India from 2015–2021: Has There Been a Change during COVID-19 Pandemic?

The COVID-19 pandemic and public health response to the pandemic has caused huge setbacks in the management of other infectious diseases. In the present study, we aimed to (i) assess the trends in numbers of samples from patients with influenza-like illness and severe acute respiratory syndrome tested for influenza and the number and proportion of cases detected from 2015–2021 and (ii) examine if there were changes during the COVID-19 period (2020–2021) compared to the pre-COVID-19 period (2015–2019) in three states of India. The median (IQR) number of samples tested per month during the pre-COVID-19 period was 653 (395–1245), compared to 27 (11–98) during the COVID-19 period (p value p value < 0.001). Interrupted time series analysis (adjusting for seasonality and testing charges) confirmed a significant reduction in the total number of samples tested and influenza cases detected during the COVID-19 period. However, there was no change in the influenza positivity rate between pre-COVID-19 (29%) and COVID-19 (30%) period. These findings suggest that COVID-19-related disruptions, poor health-seeking behavior, and overburdened health systems might have led to a reduction in reported influenza cases rather than a true reduction in disease transmission

Pan-Indian Clinical Registry of Invasive Fungal Infections Among Patients in the Intensive Care Unit: Protocol for a Multicentric Prospective Study

BackgroundFungal infections are now a great public health threat, especially in those with underlying risk factors such as neutropenia, diabetes, high-dose steroid treatment, cancer chemotherapy, prolonged intensive care unit stay, and so on, which can lead to mycoses with higher mortality rates. The rates of these infections have been steadily increasing over the past 2 decades due to the increasing population of patients who are immunocompromised. However, the data regarding the exact burden of such infection are still not available from India. Therefore, this registry was initiated to collate systematic data on invasive fungal infections (IFIs) across the country. ObjectiveThe primary aim of this study is to create a multicenter digital clinical registry and monitor trends of IFIs and emerging fungal diseases, as well as early signals of any potential fungal outbreak in any region. The registry will also capture information on the antifungal resistance patterns and the contribution of fungal infections on overall morbidity and inpatient mortality across various conditions. MethodsThis multicenter, prospective, noninterventional observational study will be conducted by the Indian Council of Medical Research through a web-based data collection method from 8 Advanced Mycology Diagnostic and Research Centers across the country. Data on age, gender, clinical signs and symptoms, date of admission, date of discharge or death, diagnostic tests performed, identified pathogen details, antifungal susceptibility testing, outcome, and so on will be obtained from hospital records. Descriptive and multivariate statistical methods will be applied to investigate clinical manifestations, risk variables, and treatment outcomes. ResultsThese Advanced Mycology Diagnostic and Research Centers are expected to find the hidden cases of fungal infections in the intensive care unit setting. The study will facilitate the enhancement of the precision of fungal infection diagnosis and prompt treatment modalities in response to antifungal drug sensitivity tests. This registry will improve our understanding of IFIs, support evidence-based clinical decision-making ability, and encourage public health policies and actions. ConclusionsFungal diseases are a neglected public health problem. Fewer diagnostic facilities, scanty published data, and increased vulnerable patient groups make the situation worse. This is the first systematic clinical registry of IFIs in India. Data generated from this registry will increase our understanding related to the diagnosis, treatment, and prevention of fungal diseases in India by addressing pertinent gaps in mycology. This initiative will ensure a visible impact on public health in the country. International Registered Report Identifier (IRRID)DERR1-10.2196/5467

Abstracts of National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020

This book presents the abstracts of the papers presented to the Online National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020 (RDMPMC-2020) held on 26th and 27th August 2020 organized by the Department of Metallurgical and Materials Science in Association with the Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, India. Conference Title: National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020Conference Acronym: RDMPMC-2020Conference Date: 26–27 August 2020Conference Location: Online (Virtual Mode)Conference Organizer: Department of Metallurgical and Materials Engineering, National Institute of Technology JamshedpurCo-organizer: Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, IndiaConference Sponsor: TEQIP-